Currently browsing posts about: Allergies

I was interested to see the FDA’s announcement that it “acknowledges” and will “exercise enforcement discretion” (translation: will not oppose) a qualified health claim linking the early introduction of peanuts into the diets of young children with severe eczema or egg allergies as a means to reduce their risk of peanut allergy.

Here’s the claim, which the FDA says manufacturers can use right away:

For most infants with severe eczema and/or egg allergy who are already eating solid foods, introducing foods containing ground peanuts between 4 and 10 months of age and continuing consumption may reduce the risk of developing peanut allergy by 5 years of age. FDA has determined, however, that the evidence supporting this claim is limited to one study. If your infant has severe eczema and/or egg allergy, check with your infant’s healthcare provider before feeding foods containing ground peanuts.

The FDA’s decision is based on:

That one study, which I’ve written about in two previous posts (see here and here).

FoodNavigator.com does occasional “special editions” in which they collect articles on particular topics from the perspective of their food-industry audience. This one is on food allergies and intolerances, about which remarkably little is known. If you are allergic or intolerant, the best you can do is hope for an accurate allergy test or do everything you can to avoid the food that triggers reactions. Good luck with that since allergies are hard to diagnose and allergenic ingredients sneak into a great many foods and are not always revealed on labels.

Food allergy is on the rise in many countries, but how many people are impacted in the US? We’ve collected some facts and figures from Food Allergy Research and Education (FARE), the world’s largest private source of funding for food allergy research; the CDC (Centers for Disease Control and Prevention); and NIAID, the lead institute at the National Institutes of Health conducting research on food allergy… Display [this site has basic statistics on prevalence and basic definitions of terms]

Soup-To-Nuts Podcast: Is low-FODMAP the new gluten-free?For the 45 million Americans who suffer from irritable bowel syndrome, identifying food that they can safely eat without triggering a flare up is a source of deep frustration that also could be a sizable market opportunity for innovative food and beverage companies that can provide an easy solution… Listen now

Introduction of peanut products into the diets of infants at high risk of developing peanut allergy was safe and led to an 81 percent reduction in the subsequent development of the allergy, a clinical trial has found…Researchers led by Gideon Lack, M.D., of King’s College London, designed a study called Learning Early About Peanut Allergy (LEAP), based on observations that Israeli children have lower rates of peanut allergy compared to Jewish children of similar ancestry residing in the United Kingdom. Unlike children in the UK, Israeli children begin consuming peanut-containing foods early in life.

Their studies were funded mainly by NIH and the UK Department of Health, but the researchers also report that their clinical trials unit was supported by the National Peanut Board, Atlanta, and that the manufacturer of Bamba supplied the products. The lead author, Gideon Lack, reports holding stock in DBV Technologies, the maker of Viaskin Peanut, a product that helps people with peanut allergies tolerate exposure to peanuts.

I’d like to see these studies repeated by fully independent researchers.

There is now scientific evidence (Level 1 evidence from a randomized controlled trial) that health care providers should recommend introducing peanut-containing products into the diets of ‘‘high-risk’’ infants early on in life (between 4 and 11 months of age) in countries where peanut allergy is prevalent because delaying the introduction of peanut can be associated with an increased risk of peanut allergy.

If these studies are right, introducing babies to the widest possible variety of foods as soon as they can handle solid foods (usually at 4 to 5 months) may well help prevent allergies later on.

Addition

A reader just sent another paper from the same authors, this one a randomized trial of six allergenic foods given to breastfed babies at 3 or 6 months of age. By one analysis, allergies developed 1 to 3 years later in 7.1% of the later-introduction group and 5.6% of the earlier-introduction group—a result that was not statistically significant. By another, allergies were much lower in the early-introduction group (2.4% vs 7.3%), especially with respect to peanut and milk allergies.

The New England Journal of Medicine has a new study that suggests the need to rethink whether to feed peanuts to babies.

As the Wall Street Journal explains, peanut allergies can be life-threatening and they are increasing among the population.

Dr. Gideon Lack and his colleagues randomly assigned infants to be fed peanuts (really, peanut butter) until they were five years old. The children fed peanuts had far fewer peanut allergies than those who were not exposed to peanuts.

Of the more than 500 infants who showed no signs of peanut allergies at the start of the trial, the prevalence of peanut allergies at age 5 was 13.7% in the avoidance group and only 1.9% in the consumption group (see the journal’s video for an easy explanation).

A result like this is extremely unlikely to have occurred by chance.

Dr. Lack got the idea for the study when he noticed that peanut allergies were rare in Israel. Israeli infants are routinely offered foods made with peanuts, whereas British and American parents have been told not to feed peanuts to young children.

The authors conclude:

Our findings showed that early, sustained consumption of peanut products was associated with a substantial and significant decrease in the development of peanut allergy in high-risk infants. Conversely, peanut avoidance was associated with a greater frequency of clinical peanut allergy than was peanut consumption, which raises questions about the usefulness of deliberate avoidance of peanuts as a strategy to prevent allergy.

The implications are clear: expose young children to peanut butter (the accompanying editorial explains how to do this safely). And to prevent choking, don’t give them peanuts until they can chew.

Food allergies pose labeling and other problems for food manufacturers. FoodQualityNews.com summarizes recent stories on what’s happening with food allergies, from the perspective of its European food industry clients.

FoodNavigator conference to address food allergy challenges: Incidence of food allergies and intolerances is on the rise in Europe, and there are big gains to be made by companies who provide products that are safe and enjoyable for sufferers. Some challenges remain, however, such as appropriate labelling, and future threshold levels.

German researchers are aiming to develop rapid detection systems to identify allergenic substances in foodstuffs, according to a workshop on analytical methods for allergen detection staged in Berlin this week.

Allergies, as I have discussed in previous posts, are difficult to diagnose and it’s hard to avoid something you are allergic to if you can’t figure out what it is. Rates of food allergies seem to be increasing, for reasons not well understood. The leading hypothesis is cleaner environments, but research can’t confirm that cause. This is one area where the trite phrase, more research needed, really means something.

A survey report in the Journal of Allergy and Clinical Immunology says that peanut allergies have tripled in the last decade. Why? The authors don’t really know although they speculate that children aren’t exposed to as much dirt as they used to be.

Are we really that much cleaner than we were 10 years ago? I doubt it. But I would very much like to know why this is happening.

My once-every-three-weeks column for the San Francisco Chronicle is set up as a Q and A. I don’t get many questions through the column, but the few that do come in are often quite challenging. This one is from a school chef wondering how to deal with kids who might be gluten intolerant – and whether gluten intolerance is becoming more common. Interesting questions! Here’s what I had to say about them. If you have questions about food and nutrition that you’d like me to answer, send them to food@sfchronicle.com (put Marion Nestle in the subject line).